Abortion does not cause risky alcohol use

Some previous research has found higher levels of alcohol use among women who have received abortions, and these findings are often used to discourage women from accessing abortion care. However, new research from the UCSF Bixby Center challenges the notion that abortion is related to increased alcohol use. Using data from the Turnaway Study, researchers found that women who had a child from an unwanted pregnancy reduced alcohol consumption over a two-year period, while women who had abortions resumed their typical pre-pregnancy alcohol consumption. This new study shows that the difference in alcohol consumption for these two groups is due primarily to reductions among women continuing pregnancies rather than increases among women having abortions.

There was no evidence that having an abortion lead to risky or problematic drinking over time, or that it caused women to start binge drinking. These new findings join others showing that abortion care is medically safe and does not have negative consequences for women.

03/17/15

Louisiana law would drastically limit abortion access

In
2014, Louisiana passed a law requiring abortion providers to have
hospital admitting privileges. The law is temporarily on hold while a court case challenging it
continues. According to new research from the
UCSF Bixby Center, this law would close
all of the state’s abortion facilities, forcing three-quarters of Louisiana
women to travel 150 miles or more each way for services.

Using
data from three of the five Louisiana abortion care facilities in the year
before the law was scheduled to take effect, Bixby Center researchers aimed to
describe who would be affected if the law went into effect. They found that:

Louisiana women in the study had traveled, on
average, 58 miles each way to have an abortion.

If Louisiana’s abortion facilities closed,
the average distance would more than triple to 208 miles each way, about the distance
from New York to Boston.

Most women who had abortions at the
three Louisiana facilities had no education beyond high school. They were also more
likely to live in areas where average incomes were below the state mean.

The study
may actually underestimate the distance women would have to travel, since three
of Louisiana­’s neighboring states—Texas, Mississippi and Alabama—have also passed
admitting privilege laws and other restrictions that could close their abortion
care facilities. Forcing women to travel further would likely contribute to
delays in care and put an additional financial burden on women. The researchers
concluded that Louisiana’s
law would put a considerable burden on many Louisiana women, particularly those
who are already financially vulnerable.

About
half of pregnancies in the U.S. are accidental, with inconsistent use and non-use
of birth control being the leading causes. For some women, going to a
healthcare provider to obtain a prescription stands in the way of using birth
control. Making oral contraceptives available without a prescription has the
potential to increase the number of women using this method and reduce gaps in
use.

New research from the UCSF Bixby Center examines how non-prescription oral
contraceptives might impact women's access, use and pregnancies, as well as public
health costs. Using national and state data, the researchers found that if women were able to obtain oral contraceptives without a prescription as a covered health insurance
benefit, there would be an 11 to 21 percent increase in the number of women
using the Pill. As a result, the rate of accidental pregnancies in the U.S.
would decrease by 7 to 25 percent.

The researchers also considered the public sector costs of
providing oral contraceptives without a prescription and of providing medical care
for unintended pregnancy. They found that the combined costs would be
reduced for public health plans that chose to cover oral contraceptives without
a prescription. Despite these cost
savings, it is relatively uncommon for public health insurance to cover
non-prescription methods of birth control.

“In the era of no-co-pay contraception, there is
still a need for over-the-counter birth control to fill the gap when women run
out of pills while traveling, for example, or for those who find it
inconvenient to get to a clinic," study co-author Dan Grossman said. "But to reach the largest number of women
most in need, it's critical that a future [non-prescription] pill be covered by
insurance.

02/25/15

Preventing cervical cancer among HIV-positive women

Cervical
cancer, caused by human papilloma virus (HPV), is a leading cause of
cancer-related death among women in low-resource settings. Some areas with the
high cervical cancer prevalence, such as sub-Saharan Africa, also have high HIV
prevalence. Among
HIV-positive women, a weakened immune system and inability to clear HPV may
lead to an increased risk of cervical cancer; studies have found a 2- to 22-fold increase in the incidence of invasive
cervical cancer among women living with HIV compared with the general
population.

The high
risk of cervical cancer among HIV-positive women underscores the urgent need
for effective cervical cancer prevention programs tailored to their needs. To
help develop such programs, researchers with the UCSF Bixby Center worked with a group of HIV-positive women with cervical cancer
in Western Kenya. The researchers saw the women six and twelve months following
a treatment to clear abnormal
cervical cells. The treatment effectively reduced the risk of cancer for up
to one year, with only 13% of women experiencing a return of cervical cancer.
However, among the women who did experience a return of the disease, the
researchers observed a high proportion of invasive cancer.

Because of the risk of developing invasive cancer after
treatment, HIV-positive women should receive continued and close follow-up care
for cervical cancer. However, the standard of care in low-resource settings
means that many cases of invasive cervical cancer could be missed. For instance, without collecting specimen
samples of cervical tissue, cases of invasive disease may be missed, especially
among HIV-positive women. The researchers call for a continued investigation of the
most cost-effective and feasible programs to prevent and treat cervical cancer
worldwide.

02/03/15

Abortion and mental health issues unrelated

Although the
relationship between abortion and mental health has been a topic of scientific debate and public interest for the past three decades, few studies have
been designed to examine this relationship specifically. Researchers with the
UCSF Bixby Center conducted a study to examine this relationship and fill this
gap in the scientific literature.

Using data
from the Turnaway Study, the researchers found that anxiety and
depression were not more common among women having an abortion. Specifically:

Among women who received an abortion, depression
and anxiety symptoms remained steady or decreased over the 2 years after the
procedure.

Levels of anxiety symptoms were initially
higher among those denied an abortion compared with those receiving one, but
the two groups converged over time.

Women who received abortion close to gestational age limits initially had similar levels of depression
and lower levels of anxiety compared to women who were denied abortions and
subsequently carried their pregnancies to term.

These
findings show that relative to unwanted childbearing, abortion does not lead to
an increased risk of mental health problems among women. Opponents of legalized abortion have
suggested that abortion is a traumatic event with severe consequences for
women’s mental health, but this study and others indicate definitively that abortion
does not cause mental health issues. Policymakers should take this into account
when legislating women’s access to safe and high-quality abortion care.